<style>
.division {
	padding-left: 20px;
}

.division li {
	list-style-type: disc;
}

.tableSettingBorder th, .tableSettingBorder td, .tableSettingBorderThL th, .tableSettingBorderThL td {
    border-color: #DEDEDE;
    border-style: solid;
    border-width: 1px;
    font-family: 微軟正黑體;
    font-size: 15px;
    padding: 3px;
}

.tableSettingBorder th, .tableSettingBorderThL th, .tableSettingBorderNormalFont th {
    background-color: #F1F1F1;
}

.ContentCenter {
    float: left;
    font-size: 12px;
    line-height: 24px;
    padding: 25px 30px 25px 40px; 
}


</style>

<div class="MemberMain"></div>


<div class="ContentCenter">

				<h1 class="title"><{t}><{$smalltitle}><{/t}></h1>
				<{if 'Y' eq $warrantyedit}>
				
				<form
					action="<{link app=yswarranty ctl=site_mywarranty act=updatereg }>"
					method="POST" id="register-form">
				<{else}>				
				<form
					action="<{link app=yswarranty ctl=site_mywarranty act=toreg }>"
					method="POST" id="register-form">
				<{/if}>
				
					<{if $reg_id}> <{input type="hidden" name="reg_id"
					value="$reg_id"}> <{/if}>
					<table  class="tableSettingBorder">
						<tr>
							<th><span style="color:#FF0000">*</span>機種</th>
							<td align="left"><{input type="text" name="product_style"
								vtype="require" value=$product_style }><br />
								∗若您輸入的機種顯示錯誤，請您嘗試點選 這裡 ，透過挑選的方式進行輸入
							</td>
						</tr>
						<tr>
							<th>機號</th>
							<td align="left"><{input type="text" name="product_no"
								value=$product_no }><br />
								∗若您的保證書上有此欄位，請務必填寫，以免您的權益受損；若無此欄位則不需填寫。
							</td>
						</tr>
						<tr>
							<th><span style="color:#FF0000">*</span>保證書編號</th>
							<td align="left"><{input type="text" name="warranty_no"
								value=$warranty_no}><br /> ∗若您的保證書上有此欄位，請務必填寫，以免您的權益受損。<br />
								∗找不到保證書編號嗎？請點此查看 <br />
							</td>
						</tr>
						<tr>
							<th><span style="color:#FF0000">*</span>購買日期</th>
							<td align="left"><{input type="date" name="purchase_date"
								value=$purchase_date }><br /> ∗提醒您：<br /> 1. 保證書務必填寫購買日期並加蓋店章。<br />
								2. 請於此欄填入"該商品保證書上之購買日期"，以避免您的保固權益損失！<br />
							</td>
						</tr>
						<tr>
							<th><span style="color:#FF0000">*</span>再次確認<br>購買日期
							</th>
							<td align="left"><{input type="date" name="purchase_date2"
								value=$purchase_date2}><br /> 必須設定與購買日期相同
							</td>
						</tr>
						<tr>
							<th><span style="color:#FF0000">*</span>購買方式</th>
							<td align="left"><{input type="radio" options=$channelopt
								name="channel" separator=' ' value=$channel}><br /> 其他:<{input
								type="text" name="channelother" value=$channelother }>
							</td>
						</tr>
						<tr>
							<th>保證書驗證碼</th>
							<td align="left"><{input type="text" name="verify_code"
								value=$verify_code }><br />
								∗若您的保證書上有此欄位，請務必填寫，以免您的權益受損；若無此欄位則不需填寫。<br /> ∗找不到保證書驗證碼嗎？請點此查看
								<br />
							</td>
						</tr>
						<tr>
							<th>原購經銷商店名</th>
							<td align="left"><{input type="text" name="reseller_name"
								value=$reseller_name }></td>
						</tr>
						<tr>
							<th>原購經銷商地址</th>
							<td align="left"><{input app=ectools type="region"
								name='reseller_region' vtype='area' value=$reseller_region}><br />
								<{input type="text" name="reseller_address"
								value=$reseller_address }>
							</td>
						</tr>
						<tr>
							<th><span style="color:#FF0000">*</span>畫面檢查碼</th>
							<td><{input type="text" required="true" size="4"
								maxlength="4" name="askverifyCode"
								onchange="replyVcodeCheck(this)"}>&nbsp;
								<img src="<{link app='b2c' ctl='site_comment' act='gen_askvcode'}>" border="1" id="askimgVerifyCode"/>
								<a href="javascript:changeimg('askimgVerifyCode')">&nbsp;<{t}>看不清楚?换个图片<{/t}></a><span></span>
							</td>
						</tr>
						<tr>
							<td colspan="2"><input type="submit" value="確認送出"></td>
						</tr>
					</table>
				</form>
				<center><{button label=$___b2c="確認送出"|t:'b2c'
					id="warranty-form-submit" type="button"}> <{button
					label=$___b2c="回前頁"|t:'b2c' id="warranty-form-cancel"
					type="button"}></center>

</div>


<script>
	$('warranty-form-submit').addEvent('click', function() {
		$('register-form').fireEvent('submit');
	});

	$('warranty-form-cancel').addEvent('click', function() {
		history.go(-1);
	});

	function changeimg(id) {
		$(id).set(
				'src',
				'<{link app="yswarranty" ctl="site_mywarranty" act="gen_askvcode"}>#'
						+ $time());

	}

	function replyVcodeCheck(input) {
		new Request.HTML({
			url : '<{link app=yswarranty ctl=site_mywarranty act=vcodecheck}>',
			update : $(input).getNext('span'),
			method : 'post',
			data : 'name='
					+ encodeURIComponent(input.value = input.value.trim())
		}).send();
	}
</script>